Acupuncture Improves Intestinal Absorption of Iron in Iron-deficient Obese Patients: A Randomized Controlled Preliminary Trial.
Acupuncture Improves Intestinal Absorption of Iron in Iron-deficient Obese Patients: A Randomized Controlled Preliminary Trial.
复制标题
针灸改善缺铁肥胖患者肠道对铁的吸收：一项随机对照初步试验
DOI：
10.4103/0366-6999.200549
复制
发表时间：
2017-03-05
影响因子：
6.1
通讯作者：
Wei SG
中科院分区：
文献类型：
--
作者：
Xie XC;Cao YQ;Gao Q;Wang C;Li M;Wei SG
背景：肥胖对铁营养状况有不良影响。铁调素介导的十二指肠铁吸收抑制是一个潜在的机制。缺铁性肥胖患者对口服铁剂治疗的反应减弱。本研究旨在评估针灸是否可以提高口服补铁治疗肥胖相关铁缺乏症（ID）的疗效。研究方法：选择60例在北京中医院就诊的ID或ID贫血（IDA）伴肥胖患者，随机分为口服铁剂联合针刺减肥组（针刺组）和口服铁剂联合假针刺组（对照组），每组30例。测量人体测量参数，并在治疗前和治疗后检测血液样本。比较两组间ID/IDA治疗结果的差异。结果如下：针刺治疗8周后，针刺组患者体重、体重指数、腰围、腰臀比均明显下降，而对照组无明显变化。口服铁剂后，针刺组血清铁（11.08 ± 2.19 mol/L）、转铁蛋白饱和度（11.26 ± 1.65%）、血红蛋白（31.47 ± 1.19 g/L）、血红蛋白（21.00 ± 2.69 g/L）的绝对值均较对照组明显升高（P均< 0.05）。同时，针刺组血清瘦素（2.26 ± 0.45 ng/ml）和铁调素（3.52 ± 1.23 ng/ml）水平明显低于对照组（8.13 ± 0.55 ng/ml）和（6.77 ± 0.84 ng/ml）水平（P < 0.05）。结论：针灸减肥可以通过改善肠道铁的吸收来增强铁替代疗法对肥胖相关性ID/IDA的治疗效果，这可能是通过下调全身瘦素-铁调素水平实现的。
Background: Obesity has an adverse effect on iron status. Hepcidin-mediated inhibition of iron absorption in the duodenum is a potential mechanism. Iron-deficient obese patients have diminished response to oral iron therapy. This study was designed to assess whether acupuncture could promote the efficacy of oral iron supplementation for the treatment of obesity-related iron deficiency (ID). Methods: Sixty ID or ID anemia (IDA) patients with obesity were screened at Beijing Hospital of Traditional Chinese Medicine and were randomly allocated to receive either oral iron replacement allied with acupuncture weight loss treatment (acupuncture group, n = 30) or oral iron combined with sham-acupuncture treatment (control group, n = 30). Anthropometric parameters were measured and blood samples were tested pre- and post-treatment. Differences in the treatment outcomes of ID/IDA were compared between the two groups. Results: After 8 weeks of acupuncture treatment, there was a significant decrease in body weight, body mass index, waist circumference, and waist/hip circumference ratio of patients in the acupuncture group, while no significant changes were observed in the control group. Oral iron supplementation brought more obvious improvements of iron status indicators including absolute increases in serum iron (11.08 ± 2.19 &mgr;mol/L vs. 4.43 ± 0.47 &mgr;mol/L), transferrin saturation (11.26 ± 1.65% vs. 1.01 ± 0.23%), and hemoglobin (31.47 ± 1.19 g/L vs. 21.00 ± 2.69 g/L) in the acupuncture group than control group (all P < 0.05). Meanwhile, serum leptin (2.26 ± 0.45 ng/ml vs. 8.13 ± 0.55 ng/ml, P < 0.05) and hepcidin (3.52 ± 1.23 ng/ml vs. 6.77 ± 0.84 ng/ml, P < 0.05) concentrations declined significantly in the acupuncture group than those in the control group. Conclusion: Acupuncture-based weight loss can enhance the therapeutic effects of iron replacement therapy for obesity-related ID/IDA through improving intestinal iron absorption, probably by downregulating the systemic leptin-hepcidin levels.